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Arvin A, Taebi M, Khazaeipour Z, Najafi A, Tafakhori A, Ranji-Bourachaloo S, Amirifard H. Sleep profiles in epilepsy patients undergoing monotherapy and polytherapy: A comparative cross-sectional study. Epilepsy Behav 2024; 155:109799. [PMID: 38642528 DOI: 10.1016/j.yebeh.2024.109799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/14/2024] [Accepted: 04/14/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Sleep disturbances commonly reported among epilepsy patients have a reciprocal relationship with the condition; While epilepsy and anti-seizure medications (ASMs) can disrupt sleep structure, disturbed sleep can also exacerbate the frequency of seizures. This study explored subjective sleep disturbances and compared sleep profiles in patients who underwent ASM monotherapy and polytherapy. METHODS We enrolled 176 epilepsy patients who completed a structured questionnaire containing demographic and clinical information and the Persian versions of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), and Patient Health Questionnaire-9 (PHQ-9) to evaluate sleep quality, insomnia, excessive daytime sleepiness (EDS), and depressive symptoms, respectively. Chi-square and Mann-Whitney U tests were employed to analyze the association between variables, and logistic regression analysis was conducted to identify factors predicting sleep disturbances. RESULTS Comparative analysis of mono/polytherapy groups revealed a significantly higher prevalence of insomnia and EDS among patients on polytherapy compared to monotherapy. However, no significant difference was found in sleep quality between the two groups. Logistic regression analysis revealed that a depressive mood serves as a robust predictor for sleep issues, whereas treatment type did not emerge as an independent predictor of sleep disturbances. CONCLUSION Our findings suggest that an increased number of ASMs does not inherently result in a higher incidence of sleep issues. Therefore, multiple ASMs may be prescribed when necessary to achieve improved seizure control. Furthermore, this study underscores the importance of comprehensive management that addresses seizure control and treating affective symptoms in individuals with epilepsy.
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Affiliation(s)
- Alireza Arvin
- School of Medicine, Tehran University of Medical Sciences (TUMS), Iran; Center for Orthopedic Trans-Disciplinary Applied Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Morvarid Taebi
- School of Medicine, Tehran University of Medical Sciences (TUMS), Iran; Tehran Heart Center, Cardiovascular Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Khazaeipour
- Brain & Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Ranji-Bourachaloo
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Amirifard
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Behkar A, Amirifard H, Samadi S, Alemohammad ZB, Golkhandan AR, Heidari R, Akbarpour S, Sadeghniiat-Haghighi K, Jalilolghadr S, Najafi A. Global practice of sleep medicine: Iran. J Clin Sleep Med 2024. [PMID: 38445659 DOI: 10.5664/jcsm.11096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
STUDY OBJECTIVES This study aimed to conduct a comprehensive review of sleep medicine in Iran, focusing on the country's advancements, challenges, and the global context. METHODS We conducted a comprehensive review of sleep medicine in Iran, using various sources to ensure a thorough analysis. The national educational curriculum for sleep medicine and guidelines on sleep clinics issued by Iran's Ministry of Health served as a foundational resource. Additionally, we gathered information from the Iranian Sleep Medicine Society (ISM) website and relevant committee data sources. To enhance our understanding of the current research landscape, we performed a targeted search on PubMed using keywords related to sleep and Iran. RESULTS The study presents a dynamic overview of sleep medicine in Iran, highlighting key advancements and challenges. Significant progress was observed in establishing standardized sleep medicine training and accredited sleep clinics. The ISM plays a pivotal role in spearheading these developments, contributing to implementing regional guidelines for sleep tests. However, challenges such as a limited number of trained specialists, a scarcity of certified sleep clinics, and obstacles to accessing sleep disorder treatments were identified. CONCLUSIONS We advocate for the implementation of increased research initiatives, nationwide education and screening programs, and proactive measures to strengthen the landscape of sleep and circadian medicine in the country.
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Affiliation(s)
- Atefeh Behkar
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Amirifard
- Iranian Center of Neurological Research (ICNR), Tehran University of Medical Sciences, Tehran, Iran
- Iranian Sleep Medicine Society, Tehran, Iran
| | - Shahram Samadi
- Iranian Sleep Medicine Society, Tehran, Iran
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Banafsheh Alemohammad
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Sleep Medicine Society, Tehran, Iran
| | - Ania Rahimi Golkhandan
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihaneh Heidari
- Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Sadeghniiat-Haghighi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Sleep Medicine Society, Tehran, Iran
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Shabnam Jalilolghadr
- Iranian Sleep Medicine Society, Tehran, Iran
- Children Growth Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Iranian Sleep Medicine Society, Tehran, Iran
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Mohammadnejhad S, Najafi A, Earnshaw VA, Mousavi ME, Fotouhi A, Akbarpour S. Sleep traits and associated factors among people living with HIV/AIDS in Iran: a two-step clustering analysis. Sci Rep 2024; 14:5076. [PMID: 38429283 PMCID: PMC10907632 DOI: 10.1038/s41598-024-53140-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 01/29/2024] [Indexed: 03/03/2024] Open
Abstract
Sleep plays an essential role in improving the quality of life of people living with HIV (PLWH); however, sleep traits in this population are not well studied. This study aims to evaluate the sleep traits and related associated factors among PLWH in Iran. A nationwide cross-sectional study was conducted with 1185 PLWH who attended Voluntary Counseling and Testing centers in 15 provinces in Iran between April 2021 and March 2022. The Berlin Obstructive Sleep Apnea questionnaire, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale and Insomnia Severity Index were used. A two-step clustering method was employed to identify the number of sleep clusters in PLWH. Prevalence of poor sleep quality, sleepiness and insomnia were 49.6%, 21.15% and 42.7% respectively. Three sleep trait clusters were identified: I. minor sleep problems (45.6%); II. Snoring & sleep apnea (27.8%), and III. poor sleep quality and insomnia (26.7%). Age (Odds Ratio (OR) 1.033, 95% Confidence Interval (CI) 1.017-1.050), academic education (OR 0.542, 95% CI 0.294-0.998) and HIV duration were associated with being in Snoring & sleep apnea cluster, while age (OR = 1.027, 95% CI 1.009-1.040) was associated with being in Poor sleep quality and insomnia cluster. PLWH with depression had higher odds of being in Poor sleep quality and insomnia cluster, and those with anxiety had higher odds of being in Snoring & sleep apnea cluster and Poor sleep quality and insomnia cluster. A significant proportion of PLWH have poor sleep quality, sleepiness, and insomnia. The identification of three distinct sleep trait clusters underscores the need for increased attention and tailored interventions to address the specific sleep issues experienced by PLWH.
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Affiliation(s)
- Safieh Mohammadnejhad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Valerie A Earnshaw
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
| | - Mohammad Ebrahimzadeh Mousavi
- Department of Human Development and Family Sciences, University of Delaware, Newark, DE, USA
- Department of Clinical Psychology, Faculty of Behavioral Science, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Fotouhi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
| | - Samaneh Akbarpour
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran.
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Najafi A, Ala M, Amali A, Hivechi N, Heidari R, Mokary Y. An Evaluation of Obstructive Sleep Apnea Patient's Quality of life Following Continuous Positive Airway Pressure and Uvulopalatopharyngoplasty. Indian J Otolaryngol Head Neck Surg 2024; 76:753-757. [PMID: 38440610 PMCID: PMC10908904 DOI: 10.1007/s12070-023-04270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/05/2023] [Indexed: 03/06/2024] Open
Abstract
Aims Obstructive sleep apnea (OSA) is characterized by episodic sleep state-dependent upper airway collapse. OSA can markedly decrease quality of life (QoL) and productivity. Continuous Positive Airway Pressure (CPAP) has been used as an effective treatment for OSA. Recently, uvulopalatopharyngoplasty (UPPP) treatment has emerged as effective management among patients with OSA, especially non-adherent ones to conventional therapies such as CPAP. Our aim was to determine whether CPAP and UPPP treatment could improve the quality of life in patients with moderate OSA. Design Prospective. Setting Patients with moderate OSA, confirmed by polysomnography from March 2019 to March 2020, participated. CPAP and UPPP treatments were considered for patients according to their preferences. The Sleep Apnea Quality of Life Index (SAQLI) questionnaire before and after treatment was completed. Methods Change in their QoL was compared between the CPAP group and UPPP treatment. In addition, QoL was compared between these groups and patients who did not receive any of these treatment methods. Results Seventy-eight patients were included in treatment groups, 40 using CPAP and 38 undergoing UPPP treatment. Furthermore, 10 patients who did not receive treatment were considered the control. Both methods of treatment significantly (p < 0.001) improved QoL, but UPPP treatment was superior (p = 0.042) to CPAP. There was a poor correlation between post-treatment BMI (0.037), Respiratory Disturbance Index (RDI) (0.096), age (0.022), and post-treatment SAQLI score. Conclusion Based on these results, CPAP and UPPP treatment can improve QoL. UPPP treatment could be considered an effective arm of OSA management among the study population.
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Affiliation(s)
- Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Moin Ala
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Amin Amali
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Hivechi
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Reihaneh Heidari
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Otorhinolaryngology Research Center, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Yousef Mokary
- Student Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Esfiokhi SHM, Norouzian MA, Najafi A. The Effect of Different Zinc Sources on Biochemical Parameters, Intestinal Morphology, Carcass Characteristics and Performance in Finishing Lambs. Biol Trace Elem Res 2024; 202:175-181. [PMID: 37088827 DOI: 10.1007/s12011-023-03675-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 04/17/2023] [Indexed: 04/25/2023]
Abstract
To investigate the effect of different sources of zinc supplements on blood serum parameters, nutrient digestibility, growth performance, carcass characteristics, and intestinal morphology, 18 male Zandi lambs (with initial body weight of 31 ± 1.2 kg and 120 ± 8 days old) were divided into three groups, six animals each in a completely random design. Experimental treatments include (1) control treatment of basal diet without zinc supplementation, (2) basal diet with 40 mg/kg of zinc supplementation from zinc sulfate source, and (3) basal diet with 40 mg/kg of zinc supplementation with origin it was organic (Zn-peptide). All lambs were kept in individual pens with cemented floor and provision of individual feeding and watering. Mean daily weight gain increased with zinc supplementation (P < 0.05), but feed intake and feed conversion ratio were not affected by zinc supplementation in the diet. Zinc supplementation increased the apparent digestibility of the dry matter (P < 0.05), but the digestibility of dietary fat, neutral detergent fiber (NDF), and acid detergent fiber (ADF) were not affected by zinc supplementation. In this experiment, the addition of organic and inorganic supplements to the diet of fattening lambs had no significant effect on serum triglyceride, cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL) and glucose concentrations, and carcass traits. The concentration of aspartate aminotransferase (AST) enzyme in the zinc sulfate group was significantly higher than the control and organic zinc groups (P < 0.05). Concentrations of blood urea nitrogen were lower in zinc fed lambs, compared to control (P ≤ 0.05). The villi width in the duodenum was higher in the zinc supplementation treatments (P < 0.05). Also, in the ileum section, the height of the villi in the treatment of zinc sulfate supplement was higher, compared to the complement and control (P < 0.05). The results of this study showed that Zn supplementation, regardless of its source, improved growth performance in fattening lambs. However, no effect was observed on feed intake and efficiency, carcass traits, and blood parameters.
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Affiliation(s)
- S H Mousavi Esfiokhi
- Department of Animal and Poultry Sciences, College of Abouraihan, University of Tehran, Tehran, Iran
| | - M A Norouzian
- Department of Animal and Poultry Sciences, College of Abouraihan, University of Tehran, Tehran, Iran.
| | - A Najafi
- Department of Animal and Poultry Sciences, College of Abouraihan, University of Tehran, Tehran, Iran
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Shahbazi M, Heidari R, Tafakhori A, Samadi S, Nikeghbalian Z, Amirifard H, Najafi A. The effects of atomoxetine and trazodone combination on obstructive sleep apnea and sleep microstructure: A double-blind randomized clinical trial study. Sleep Med 2024; 113:13-18. [PMID: 37979502 DOI: 10.1016/j.sleep.2023.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/20/2023]
Abstract
STUDY OBJECTIVES we aimed to compare the effects of atomoxetine and trazodone (A-T) in combination with placebo in patients with obstructive sleep apnea (OSA). METHODS This randomized, placebo-controlled, double-blind, crossover trial study was conducted in adults with OSA referred to a Sleep Clinic. Participants with eligibility criteria were recruited. Patients were studied on two separate nights with one-week intervals, once treated with trazodone (50 mg) and atomoxetine (80 mg) combination and then with a placebo and the following polysomnography tests. RESULTS A total of 18 patients with OSA completed the study protocol, 9(50%) were male, the mean age was 47.5 years (SD = 9.8) and the mean Body mass index of participants was 28.4 kg/m2 (SD = 3.4). Compared with the placebo, the A-T combination resulted in significant differences in AHI (28.3(A-T) vs. 42.7 (placebo), p = 0.025), duration of the REM stage (1.3%TST (A-T) vs. 13.1%TST (placebo), p = 0.001), and the number of REM cycles (0.8 (A-T) vs. 4.7 (placebo), p = 0.001), number of apneas (38.3 (A-T) vs. 79.3 (placebo), p = 0.011), number of obstructive apneas (37.2 (A-T) vs. 75.2 (placebo), p = 0.011), oxygen desaturation index (29.5 (A-T) vs. 42.3 (placebo), p = 0.022) and number of respiratory arousals (43.2 (A-T) vs. 68.5 (placebo), p = 0.048). This decrement effect did not change among those with a low-arousal phenotype of OSA. CONCLUSIONS The A-T combination significantly improved respiratory events' indices compared with placebo in patients with OSA. This combination is recommended to be assessed in a large trial. It could be an alternative for those who do not adhere to the standard available treatments for OSA.
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Affiliation(s)
- Mojtaba Shahbazi
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reihaneh Heidari
- Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Tafakhori
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Samadi
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Nikeghbalian
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Amirifard
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran; Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Arezu Najafi
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran; Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Sadeghniiat-Haghighi K, Najafi A, Eftekhari S, Behkar A, Tarkhan S. Characterization of risk factors for obstructive sleep apnea and its association with absenteeism among nurses. Nursing 2024; 54:49-54. [PMID: 38126988 DOI: 10.1097/01.nurse.0000995580.16617.2c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
PURPOSE To characterize risk factors associated with obstructive sleep apnea (OSA) and its relationship with nurses' absenteeism. METHODS A cross-sectional study was conducted from 2018 to 2020 at a 1,000-bed academic hospital complex and biomedical research facility in Tehran, Iran. Participants were selected through consecutive sampling after obtaining ethical approval and informed consent. Data on demographics, medical conditions, occupational characteristics, and absenteeism were collected through face-to-face interviews. The STOP-Bang questionnaire was utilized to assess the probability of OSA. Statistical tests included the Mann-Whitney U, t-test, Chi-square, and multivariable regression. RESULTS In this study involving 304 nurses, the majority were female (81.3%), with an average age of 35. About 27 participants (8.9%) had a high probability of OSA, with male sex, older age, higher body mass index, neck circumference, and diastolic BP identified as the main determinants of OSA. Additionally, shift work and night shifts were associated with increased absenteeism, while sex showed no significant association with absenteeism rates among nurses. CONCLUSION Male sex, neck circumference (obesity), night shifts, and diastolic BP can predict OSA risk. However, unauthorized absence from work is not associated with a high risk for OSA (STOP-BANG ≥3) or the individual risk factors of OSA.
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Affiliation(s)
- Khosro Sadeghniiat-Haghighi
- At Tehran University of Medical Sciences in Tehran, Iran, Khosro Sadeghniiat-Haghighi is a professor at the Sleep Breathing Disorders Research Center, Arezu Najafi is an associate professor at the Occupational Sleep Research Center, Sahar Eftekhari is an associate professor at the Center for Research on Occupational Diseases, Atefeh Behkar is a research assistant at the Occupational Sleep Research Center, and Samareh Tarkhan works at the Center for Research on Occupational Diseases
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Asgari S, Najafi A, Sadeghniiat-Haghighi K, Najafi F, Safari-Faramani R, Behkar A, Akbarpour S. Population-based cross-sectional study of sex-specific dose-response associations between night sleep duration and hypertension in Islamic Republic of Iran. East Mediterr Health J 2023; 29:954-965. [PMID: 38279864 DOI: 10.26719/emhj.23.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 07/24/2023] [Indexed: 01/29/2024]
Abstract
Background Several studies have suggested that sleep disorders have adverse effects on blood pressure. However, the findings remain controversial and only a few studies have investigated the association between sleep duration and hypertension among all age and sex subgroups. Aim To evaluate the dose-response association between sleep duration and blood pressure in the Iranian population using the Ravansar non-communicable disease cohort study. Methods This was a cross-sectional study of 9865 participants aged 35-65 years from the 2014-2017 Ravansar non-communicable disease cohort study. Night sleep duration was classified as ≤5 hours, 6 hours, 7 hours, 8 hours, 9 hours, and ≥10 hours. The association between self-reported sleep duration and hypertension was examined using multivariable logistic regression in STATA version 14. Restricted cubic spline analysis showed the dose-response association between sleep duration and hypertension. Results The age-adjusted prevalence of hypertension was 16.50% among men, 24.20% among women and 20.50% in the total population. Compared with reference sleep duration (7 hours) in the total population, the multivariable odds ratio [OR (95% CI)] for hypertension was 0.70 (0.55-0.88) for the group with 9 hours sleep duration and 0.90 (0.74-1.09) for the group with ≤5 hours sleep duration. Among pre-menopausal women, we observed an inverse association between 9 hours sleep duration and hypertension [0.62 (0.42-0.90)]. The age-adjusted cubic spline suggested a linear inverse association between sleep duration and prevalence of hypertension among men and the total population and a non-linear association among women. Conclusion Longer sleep duration (from 9 hours) had a negative association with hypertension. Further studies are needed to identify the risk factors associated with sleep duration and hypertension among the general population in the Islamic Republic of Iran.
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Affiliation(s)
- Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Khosro Sadeghniiat-Haghighi
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
| | - Roya Safari-Faramani
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
| | - Atefeh Behkar
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Samaneh Akbarpour
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Sadeghniiat-Haghighi K, Akbarpour S, Behkar A, Moradzadeh R, Alemohammad ZB, Forouzan N, Mouseli A, Amirifard H, Najafi A. A nationwide study on the prevalence and contributing factors of obstructive sleep apnea in Iran. Sci Rep 2023; 13:17649. [PMID: 37848453 PMCID: PMC10582253 DOI: 10.1038/s41598-023-44229-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 10/05/2023] [Indexed: 10/19/2023] Open
Abstract
Reliable obstructive sleep apnea (OSA) prevalence information in Iran is lacking due to inconsistent local study results. To estimate OSA prevalence and identify clinical phenotypes, we conducted a nationally representative study using multi-stage random cluster sampling. We recruited 3198 individuals and extrapolated the results to the entire Iranian population using complex sample survey analyses. We identified 3 clinical phenotypes as "sleepy," "insomnia," and "restless legs syndrome (RLS)." The prevalence of OSA was 28.7% (95%CI: 26.8-30.6). The prevalence of "sleepy," "insomnia," and "RLS" phenotypes were 82.3%, 77.8%, and 36.5% in women, and 64.8%, 67.5%, and 17.9% in men, respectively. "Sleepy" and "insomnia" phenotypes overlapped the most. Age (OR: 1.9), male sex (OR: 3.8), BMI (OR: 1.13), neck circumference (OR: 1.3), RLS (OR: 2.0), and insomnia (OR: 2.3) were significant OSA predictors (p-values: 0.001). In men, "sleepy" phenotype was associated with youth and unmarried status but not in women. The "insomnia" phenotype was associated with shorter sleep duration in women; cardiovascular diseases (CVD), urban residency, and shorter sleep duration in men. "RLS" phenotype was associated with shorter sleep duration and CVD in women and older age, lower educational level, CVD, and hypertension in men. The findings point to the need for funding of OSA screening in Iran, for a different assessment of men and women, and for future sleep research to consider overlapping phenotypes.
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Affiliation(s)
- Khosro Sadeghniiat-Haghighi
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Atefeh Behkar
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahmatollah Moradzadeh
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Zahra Banafsheh Alemohammad
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Forouzan
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Mouseli
- Department of Health Services Management, Social Determinants in Health Promotion Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Hamed Amirifard
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Lim DC, Najafi A, Afifi L, Bassetti CLA, Buysse DJ, Han F, Högl B, Melaku YA, Morin CM, Pack AI, Poyares D, Somers VK, Eastwood PR, Zee PC, Jackson CL. The need to promote sleep health in public health agendas across the globe. Lancet Public Health 2023; 8:e820-e826. [PMID: 37777291 PMCID: PMC10664020 DOI: 10.1016/s2468-2667(23)00182-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 10/02/2023]
Abstract
Healthy sleep is essential for physical and mental health, and social wellbeing; however, across the globe, and particularly in developing countries, national public health agendas rarely consider sleep health. Sleep should be promoted as an essential pillar of health, equivalent to nutrition and physical activity. To improve sleep health across the globe, a focus on education and awareness, research, and targeted public health policies are needed. We recommend developing sleep health educational programmes and awareness campaigns; increasing, standardising, and centralising data on sleep quantity and quality in every country across the globe; and developing and implementing sleep health policies across sectors of society. Efforts are needed to ensure equity and inclusivity for all people, particularly those who are most socially and economically vulnerable, and historically excluded.
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Affiliation(s)
- Diane C Lim
- Miami Veterans Affairs Healthcare System, Miami, FL, USA; Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami, Miami, FL, USA
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran; Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Lamia Afifi
- Clinical Neurophysiology Unit, School of Medicine, Cairo University Hospitals, Cairo, Egypt
| | | | - Daniel J Buysse
- Center for Sleep and Circadian Science, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Fang Han
- Department of Sleep Medicine, Peking University People's Hospital, Beijing, China
| | - Birgit Högl
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute: Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia; Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia
| | - Charles M Morin
- Department of Psychology, and CERVO Brain Research Center, Université Laval, Quebec City, QC, Canada
| | - Allan I Pack
- Sleep Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dalva Poyares
- Psychobiology Department, Sleep Medicine Division, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Virend K Somers
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Peter R Eastwood
- Health Futures Institute, Murdoch University, Perth, WA, Australia
| | - Phyllis C Zee
- Division of Sleep Medicine, Center for Circadian and Sleep Medicine, Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC, USA; Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA.
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11
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Hadavandsiri F, Shafaati M, Mohammad Nejad S, Ebrahimzadeh Mousavi M, Najafi A, Mirzaei M, Narouee S, Akbarpour S. Non-communicable disease comorbidities in HIV patients: diabetes, hypertension, heart disease, and obstructive sleep apnea as a neglected issue. Sci Rep 2023; 13:12730. [PMID: 37543699 PMCID: PMC10404291 DOI: 10.1038/s41598-023-39828-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 07/31/2023] [Indexed: 08/07/2023] Open
Abstract
The present study evaluates the non-communicable disease (NCD) patterns and related risk factors among people living with HIV (PLWH) in Iran. This national cross-sectional survey study was conducted on 1173 confirmed PLWHs with a mean age of 35.35 (56.82 Over 50 years old, 33.90 Under 50 years old) admitted from 15 different provinces in the country. Logistic regression was used to analyze the association of factors with having at least one NCD comorbidity. From 1173 PLWH, 225(19.18%) participants experienced at least one NCD (15.20% and 38.69% among under- and over-50-year-old patients, respectively). The prevalence of heart disease, hypertension, diabetes, and sleep apnea among all patients was 1.59%, 2.05%, 1.55%, and 10.26%, respectively. The similar prevalence for each NCD among those over 50 years was 10.11%, 15.71%, 9.01%, 25.44%, and 1.01%, 1.12%, 1.04%, and 9.23% among those under 50 years, respectively. The odds of being at risk of at least one NCD stood higher in patients over 50 years (ORadj = 2.93, 95% CI 1.96-4.37), married (ORadj = 2.48, 95% CI 1.41-4.35), divorced or widowed (ORadj = 2.78, 95% CI 1.48-5.20), and obese (ORadj = 3.82, 95% CI 2.46-5.91). According to our findings regarding the prevalence of NCDs among patients under 50 years of age, we recommend that policymakers give greater consideration to this group in the screening and care programs for NCDs since adults and the elderly are both vulnerable to the risk factors for developing NCDs.
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Affiliation(s)
- Fatemeh Hadavandsiri
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shafaati
- Research Center for Antibiotic Stewardship and Antimicrobial Resistance, Tehran University of Medical Science, Tehran, Iran.
- Department of Microbiology, Faculty Science, Jahrom Branch, Islamic Azad University, Jahrom, Iran.
| | - Safieh Mohammad Nejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical, Tehran, Iran
| | | | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Mirzaei
- Hamadan Health Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Sakineh Narouee
- Department of Epidemiology, Kerman University Medical of Sciences, Kerman, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran.
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12
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Akrami M, Hosamirudsari H, Faraji N, Behnush B, Goudarzi F, Hesari E, Akbarpour S, Najafi A, Nateghi S. Sputnik V vaccine-related complications and its impression on inflammatory biomarkers in healthcare providers. Indian J Med Microbiol 2023; 43:79-84. [PMID: 36357266 PMCID: PMC9638950 DOI: 10.1016/j.ijmmb.2022.10.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/03/2022] [Accepted: 10/21/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE The current pandemic made scientists create new platforms of vaccines to fight against SARS-CoV-2. Without a doubt, the new forms of present vaccines could develop a diversity of unknown complications. Sputnik V vaccine with two different adenovirus vectors (Ad26 priming and Ad5 boost) was first announced safe and effective by Russia. However, there are controversies surrounding this vaccine such as the possible decline of its immunogenicity and diminished neutralizing capacity against some Covid-19 variants. In addition, its impression on serum biomarkers is not clearly surveyed. The present study aimed to evaluate the frequency of Sputnik V vaccine-related complications and its impression on inflammatory and hematologic biomarkers. MATERIALS &METHODS An observational cohort study was performed to evaluate the side effects and serum biomarkers changes in healthcare workers receiving Sputnik V vaccine. The vaccine adverse events were recorded daily within 60 days. The blood samples were obtained before vaccination, and on the10th day after each dose of vaccination. The prevalence of all complications and inflammatory biomarkers levels were compared between two doses. All analyses were performed using SPSS software version 22.0. RESULTS Totally, 126 participants completed the study. The mean age was 37.19 ± 7.73 years. The prevalence of all complications was higher following the first dose than the second dose. The most common side effects were pain at the injection site, body pain, fever, headache, weakness, vertigo, sore throat and sleep disorder. The hematocrit, mean corpuscular volume of red blood cells and neutrophils count declined following vaccination significantly (P-value; 0.04, 0.039, 0.000 respectively). CONCLUSION It seems the side effects of Sputnik-V vaccine are mild and decrease significantly after the second dose. The decreasing level of hematocrit, MCV and neutrophil count was found significant following vaccination.
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Affiliation(s)
- Majid Akrami
- Department of Anesthesiology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadiseh Hosamirudsari
- Department of Infectious Diseases, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Neda Faraji
- Department of Internal Medicine, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Behnush
- Department of Forensic Medicine. Tehran University of Medical Sciences, Tehran, Iran
| | - Forough Goudarzi
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Hesari
- School of Public Health, Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Nateghi
- Department of Cardiology, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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13
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Izadi N, Najafi A, Sadeghniiat-Haghighi K, Mohammadi H. Characterization of Long COVID and Its Contributing Factors among a Population of Health Care Workers in a 6-Month Follow-up. Med J Islam Repub Iran 2023; 37:29. [PMID: 37180854 PMCID: PMC10167639 DOI: 10.47176/mjiri.37.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Indexed: 05/16/2023] Open
Abstract
Background Health care workers (HCWs) are at the frontline of the fight against the coronavirus disease 2019 (COVID-19). Long COVID is defined as "the persistence of some symptoms of COVID-19, more than 4 weeks after the initial infection." The aim of the present study was to investigate the prevalence of long COVID status among HCWs in the largest hospital complex of Iran. Methods In this cross-sectional study, all patients with COVID-19 who had taken sick leave were included in the study (n = 445). Data regarding sick leave characteristics were collected from the records of the nursing management department of the hospital. Study variables included demographic and occupational information, variables related to mental health assessment, organ systems involved in COVID-19, and duration of symptoms. Frequencies, percentage distributions, means, standard deviation, and range (minimum, maximum) were used as descriptive analysis methods. Associations between symptoms' persistency and clinical characteristics were assessed by logistic and linear regressions. Results Age, N95 mask use, and respiratory protection significantly contributed to the persistence of COVID-19 symptoms (P < 0.05). The prevalence of long COVID among HCWs was 9.44% among 445 participants. The loss of taste persisted longer than the other symptoms before returning to normal. Among the postrecovery complications asked, anxiety was the most common persistent mental symptom (58.5%), followed by gloomy mood (46.3%) and low interest (46.2%), respectively. Conclusion HCWs with COVID-19 symptoms had prolonged symptoms of COVID-19 that can affect their work performance, thus, we recommend evaluating COVID-19 symptoms in HCWs with infection history.
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Affiliation(s)
- Nazanin Izadi
- Center for Research on Occupational Disease, Tehran University of Medical
Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of
Medical Sciences, Tehran, Iran
| | | | - Hosein Mohammadi
- Department of Occupational Medicine, Faculty of Medicine, Tehran University of
Medical Sciences, Tehran, Iran
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14
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Ojaghi H, Najafi A. Infectious keratitis: an update on the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis. Eur Rev Med Pharmacol Sci 2022; 26:9021-9029. [PMID: 36524521 DOI: 10.26355/eurrev_202212_30577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study aimed to assess the prevalence, risk factors, culture results, clinical features, visual outcomes, and therapeutic strategies of infectious keratitis after surface ablation (PRK). PATIENTS AND METHODS This single-center prospective case-series review comprised 6500 eyes of 3400 patients undergoing PRK operation successively at the Ardabil Noor Surgical Center between January 1, 2003, and February 1, 2020. The incidence, risk factors, and clinical course were recorded for these samples. RESULTS Three clinical and culture-proven cases of infectious keratitis in three eyes of three patients were diagnosed during the study period. Post-operative keratitis was observed in cases 1 and 2 after 3 days and in case 3 after 112 days. The results of cultures were positive in all three cases. The isolated microorganisms were Staphylococcus species in cases 1 and 2 and Candida Albicans in case 3. The final corrected distance visual acuity was 20/25 and 20/20 in cases 1 and 2, respectively, and hand motion in case 3. All three patients had some risk factors such as well-controlled familial Mediterranean fever, mild Meibomian gland dysfunction, and the healthcare environment of the patient's wife in case 1, contact lens manipulation in case 2, and dry eye in case 3. CONCLUSIONS The prevalence of infectious keratitis after PRK was 0.046%. Infectious keratitis is one of the complications of PRK that can threaten patients' vision. Accordingly, proper preoperative clinical history taking, adequate eye exam and aggressive management can help maintain good eyesight in patients who undergo PRK surgery.
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Affiliation(s)
- H Ojaghi
- Department of Surgery, School of Medicine and Allied Medical Sciences, Imam Reza Hospital, Ardabil University of Medical Sciences, Ardabil, Iran.
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15
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Erfanian R, Sohrabpour S, Najafi A, Heidari F, Sadeghniiat-Haghighi K. Effect of Otolaryngology Residency Program Training on Obstructive Sleep Apnea Practice. Indian J Otolaryngol Head Neck Surg 2022; 74:4579-4586. [PMID: 36742537 PMCID: PMC9895653 DOI: 10.1007/s12070-021-02718-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
According to the importance of management of obstructive sleep apnea syndrome by otolaryngologists, this study was designed to investigate knowledge, attitudes and practice of junior and senior residents of otolaryngology and evaluate the effect of current residency training program on choosing the first lines of treatment. A total of 110 residents of otolaryngology were selected. Our study tools were obstructive sleep apnea knowledge and attitudes (OSAKA and OSAKA-KIDS) questionnaires. The participants were classified as junior and senior. Senior residents had significantly higher total knowledge score for OSAKA based on independent t test (12.73 Vs. 10.52). No significant difference was observed for OSAKA-KIDS (11.31 Vs. 10.69). The most frequent choice for the first line was CPAP (63.8%) and weight loss (41.5%) among junior and senior residents, respectively. Although the knowledge of otolaryngology residents increased during their program, the choice of first line treatment in obstructive sleep apnea was different between junior and senior residents. We found a need for further multidisciplinary education for residents especially in the management of sleep apnea particularly toward CPAP usage and this syndrome in pediatrics.
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Affiliation(s)
- Reza Erfanian
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saeed Sohrabpour
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farrokh Heidari
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Sadeghniiat-Haghighi
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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16
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Sadeghniiat-Haghighi K, Abdullah H, Najafi A, Alemohammad ZB, Ahmadi Jazi K, Erfanian R. Patients with Obstructive Sleep Apnea Symptoms Referral to Otolaryngologists in Iranian Residency Entrance Examination Volunteers: The Effect of Source of Education and Level of Knowledge. Indian J Otolaryngol Head Neck Surg 2022; 74:4862-4869. [PMID: 36742911 PMCID: PMC9895620 DOI: 10.1007/s12070-020-02341-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 12/15/2020] [Indexed: 02/07/2023] Open
Abstract
Obstructive sleep apnea (OSA) has various complications for individuals' health. This study aimed to evaluate the factors for referring obstructive sleep apnea patients to otolaryngologists in Iranian residency entrance examination volunteers. This cross-sectional study recruited volunteer participants from the Iranian Residency Entrance Examination on March 2, 2018. The Obstructive Sleep Apnea Knowledge and Attitudes (OSAKA)/the Obstructive Sleep Apnea Knowledge and Attitudes in Children (OSAKA-KIDS) Questionnaires were distributed among residents attending exam preparation. Number of years working as a physician, number of adult and pediatric patients visited during the academic rank in residency examination, and the main specialty during general physician education in which they get familiar with obstructive sleep apnea were documented. The effect of the mentioned variables evaluated on patient referral preference specialty. Of the 95 volunteers, 57.9% were female; mean age was 29.6 ± 3.3 years. The overall knowledge score of the OSAKA questionnaire was 9.85 ± 3.9 and for the OSAKA-KIDS questionnaire was 9.2 ± 4.9. In patients under 18 years of age, the most frequent referrals were from otolaryngology specialists (51.2%). The only factor which had positive significant effect on adult patient referral preference was source of obstructive sleep apnea knowledge during general physician taring (p < 0.001). Given the low awareness about OSA in candidates for the residency entrance exam and the high importance of this treatable disease, the need for comprehensive training courses during residency is warranted and the adequacy of sleep apnea education through all involved specialty during general physician education should be improved.
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Affiliation(s)
| | - Hakima Abdullah
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Amir Alam Hospital Complexs, Sa’adi Street, P.O. Box: 14155-6446, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Reza Erfanian
- Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Amir Alam Hospital Complexs, Sa’adi Street, P.O. Box: 14155-6446, Tehran, Iran
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17
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Soroush MZ, Sadeghniiat K, Najafi A, Shahmansouri N. Dream Emotion Recognition through EEG Nonlinear Analysis. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Amirifard H, Jameie M, Akbarpour S, Haghighi KS, Shojaei M, Heidari R, Najafi A. Sleep microstructure and clinical characteristics of patients with restless legs syndrome. J Clin Sleep Med 2022; 18:2653-2661. [PMID: 35924664 PMCID: PMC9622991 DOI: 10.5664/jcsm.10184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Restless legs syndrome (RLS) is a sleep-related movement disorder, often accompanied by sleep disruption. Obstructive sleep apnea (OSA) has a controversial prevalence among patients with RLS. We evaluated the clinical and sleep features of patients who attended our sleep clinic considering RLS and OSA. METHODS In this cross-sectional study, we obtained health records of 1,497 patients during 2015-2019 who underwent polysomnography (PSG). Baseline characteristics, sleep-related and RLS questionnaires, and sleep microstructure were assessed. Descriptive and analytical assessments were performed. RLS was assessed according to the International Restless Legs Syndrome Study Group criteria. RESULTS RLS was found in 19.4% of patients, with more prevalence among women (26.9% vs 16.4%). RLS affected 19.1% of patients with OSA. Patients with RLS were significantly older with higher insomnia and depression and worse PSG results. As the respiratory disturbance index increased, the odds of RLS slightly decreased (adjusted odds ratio [95% confidence interval]: 0.80 [0.67-0.94]). The odds of OSA (respiratory disturbance index ≥ 5) was not affected by RLS. OSA in patients with RLS was significantly associated with a higher limb movement index. RLS in patients with OSA was significantly associated with higher insomnia, depression, and limb movement index (men and women), higher wake after sleep onset and percentage of N1 sleep (men), and lower sleep efficiency (men). CONCLUSIONS Patients with RLS had worse PSG results, higher insomnia, and depression. Although men with OSA+/RLS+ had worsened PSG results, PSG parameters in women with OSA+/RLS+ did not differ from the OSA+/RLS- group. Patients with either OSA or RLS should be evaluated for possible comorbidities, including insomnia and depression. Notably, sex-specific characteristics need more consideration in sleep clinics. CITATION Amirifard H, Jameie M, Akbarpour S, et al. Sleep microstructure and clinical characteristics of patients with restless legs syndrome. J Clin Sleep Med. 2022;18(11):2653-2661.
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Affiliation(s)
- Hamed Amirifard
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Jameie
- Iranian Center of Neurological Research, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahsa Shojaei
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Heidari
- Otolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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19
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Najafi A, Akbarpour S, Najafi F, Safari-Faramani R, Sadeghniiat-Haghighi K, Aghajani F, Asgari S, Aleebrahim F, Nakhostin-Ansari A. Prevalence of short and long sleep duration: Ravansar NonCommunicable Disease (RaNCD) cohort study. BMC Public Health 2022; 22:1631. [PMID: 36038891 PMCID: PMC9422113 DOI: 10.1186/s12889-022-14061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 08/25/2022] [Indexed: 11/14/2022] Open
Abstract
Background Prevalence of short and long sleep duration varies in different countries and changes over time. There are limited studies on Iranians’ sleep duration, and we aimed to evaluate the prevalence of short and long sleep duration and associated factors among people living in Kermanshah, Iran. Methods This population-based cross-sectional study was conducted between November 2014 and February 2017. Data was collected from 10,025 adults aged 35 to 65 years using census sampling, and we evaluated the short and long sleep duration (≤ 6 and ≥ 9 h, respectively) and its relation with the socio-demographic factors and health-related status of the participants. Results Mean age of participants was 48.1 years (standard deviation = 8.2), and 47.4% of participants were male. Of our participants, 11.6% had short, and 21.9% had long sleep duration. Age ≥ 50 years, female gender, being single, mobile use for longer than 8 h per day, working in night shifts, moderate and good levels of physical activity, BMI ≥ 30, past smoking, and alcohol use were associated with short sleep duration (P < 0.05). Female gender and living in rural areas were associated with long sleep duration (P < 0.05). Conclusion In the Ravansar population, short and long sleep duration are prevalent, with long sleep duration having higher prevalence. People at risk, such as night shift workers, as well as modifiable factors, such as mobile phone use, can be targeted with interventions to improve sleep hygiene. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14061-4.
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Affiliation(s)
- Arezu Najafi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farid Najafi
- Department of Epidemiology, School of Health, Research Center for Environmental Determinants of Health, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Roya Safari-Faramani
- Department of Epidemiology, School of Health, Research Center for Environmental Determinants of Health, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Khosro Sadeghniiat-Haghighi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Sleep Breathing Disorders Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Aghajani
- Research Development Center, Arash Women's Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Samaneh Asgari
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Forugh Aleebrahim
- School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Neuromusculoskeletal Research Center, Iran University of Medical Sciences, Tehran, Iran.
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20
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Mehrabi Nejad MM, Najafi A, Haji Ghadery A, Izadi N, Alemohammad ZB, Shabani M, Saraei M. Association of sleep characteristics and respiratory symptoms at a smelting factory. Work 2022; 72:737-743. [DOI: 10.3233/wor-213637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND: Sleep disturbance including insomnia and poor sleep quality has been shown to be a major health determinant in occupational settings. Specific occupational exposures to hazards in most workplaces can lead to various health problems, especially sleep problems. OBJECTIVE: The study aimed to investigate sleep characteristics, and their relationships with work-related exposures, demographics, and other related variables in workers of a smelting factory. METHODS: This cross-sectional study was carried out on workers in a 40-year smelting factory located in the East of Tehran Province. A total of 200 male participants were included in the study. Among them, 51 workers were from the production process staff and the rest were office workers. Their shifts were from 6 AM to 5 PM. All participants were asked about demographic characteristics and exposure to respiratory pollutants. All participants answered validated Persian versions of the Insomnia Severity Index (ISI) and the Pittsburgh Sleep Quality Index (PSQI). RESULTS: The means (SD) of age and BMI were 39.1 (8.9) years and 26.8 (4.5) kg/m2, respectively. Among all participants, 51 (25.5%) experienced exposure to a respiratory pollutant. Among all workers, 96 (48%) experienced poor sleep quality and 87 (43.5%) and 10 (5%) had subthreshold and clinical insomnia, respectively. The mean (SD) night sleep duration was 6.4 (0.96) hours. Data analysis illustrated a significant positive relationship between exposure to respiratory pollutants and insomnia (p-value = 0.03). Howewer, this association between sleep quality and exposure to repiratory pollutants was not significant (p-value = 0.25). Further analysis with binominal regression showed participants with exposure to respiratory pollutants were more susceptible to clinical insomnia (p-value = 0.02, exp(B) = 0.213), and after regressing out the effect of smoking, participants with exposure to respiratory pollutants remained susceptible to clinical insomnia. A lower night sleep duration was observed among participants with exposure to inhalational material (p-value = 0.05). CONCLUSIONS: Occupational exposures to hazardous material, including inhalational exposures, could cause sleep disturbance, which warrants more attention paid by sleep specialists.
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Affiliation(s)
- Mohammad Mehdi Mehrabi Nejad
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolkarim Haji Ghadery
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Izadi
- Department of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahya Shabani
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Center for Research on Occupational Diseases (CROD), Tehran University of Medical Sciences, Tehran, Iran
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21
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Alemohammad ZB, Jamshidi S, Najafi A. Periodic hypersomnolence in a young female patient: a case report and literature review. Egypt J Neurol Psychiatry Neurosurg 2022. [DOI: 10.1186/s41983-022-00466-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Kleine–Levin syndrome (KLS) is a disease with periodic hypersomnolence accompanied by abnormal behavior with a rare prevalence in female.
Case presentation
Here, we report a young lady with chief complaint of hypersomnolence for 6 years of visits and any history of sleep attack, sleep paralysis, and cataplexy. Polysomnography was performed for the patient. The respiratory disturbance index was normal. In MSLT the patient had two SOREMs with mean sleep latency of 7 min. She was diagnosed as Kleine–Levin syndrome as the sleepiness symptoms had a periodic pattern without other characteristics of central hypersomnolence disorders. The patient did not report behavioral characteristics of KLS reported in previous literature. She improved spontaneously after a while in follow-ups without any further treatment.
Conclusions
Although KLS is reported rarely in female gender and there are previous defined behavioral symptoms for this syndrome, periodic pattern of sleepiness should raise this diagnosis after exclusion of other hypersomnolence causes.
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22
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Akbarpour S, Nakhostin-Ansari A, Sadeghniiat Haghighi K, Etesam F, Alemohammad ZB, Aghajani F, Najafi A. COVID-19 Fear Association with Depression, Anxiety, and Insomnia: A National Web-Based Survey on the General Population. Iran J Psychiatry 2022; 17:24-34. [PMID: 35480134 PMCID: PMC8994844 DOI: 10.18502/ijps.v17i1.8046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 05/19/2021] [Accepted: 06/06/2021] [Indexed: 12/28/2022]
Abstract
Objective: COVID-19 pandemic has influenced almost every country worldwide. Being in a pandemic situation can cause psychological distress to people, which can lead to sleep disorders. The present study aimed to assess prevalence of depression, anxiety, and insomnia among Iranian people and their relations with COVID-19 fear in the early stages of COVID-19 pandemic. Method: A cross-sectional and population-based online study was designed. We created an online form and used Fear of COVID-19 scale (FCV-19), Generalized Anxiety Disorder 2 scale (GAD-2), Patient Health Questionnaire-2 (PHQ-2), and Insomnia Severity Index (ISI), to assess fear of COVID-19, anxiety, depression, and insomnia, respectively. We sent the link to the online survey to Iranians interested in participating in the study via social media, and 1223 Iranian completed the form. Results: A total of 1223 individuals with a mean age of 39.82 ± 10.75 years participated in the study. Prevalence of insomnia, depression and anxiety among our participants were 55.2%, 61.5%, and 50.9%, respectively. The mean FCV-19 score among the participants was 19.70 ± 5.08. Insomnia was more common among those who were 50 years or older. Fear of COVID-19 was related to a more risk of progression toward depression, anxiety, and insomnia. Conclusion: Fear of COVID-19 has a considerable association with depression, anxiety, and insomnia in the pandemic, and strategies to reasonably decrease people’s fears can help to reduce incidence of psychological issues during the pandemic.
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Affiliation(s)
- Samaneh Akbarpour
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran.,Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khosro Sadeghniiat Haghighi
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran.,Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Farnaz Etesam
- Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Department of Psychiatry, Psychosomatic Medicine Research Center, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Banafsheh Alemohammad
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran.,Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Aghajani
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Sleep Breathing Disorders Research Center (SBDRC), Tehran University of Medical Sciences, Tehran, Iran.,Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Shabani M, Rahimi B, Mehrabi Nejad MM, Erfanian R, Najafi A. Daytime Hypersomnolence in COVID-19: A Case Report and Literature Review. ACTA 2021. [DOI: 10.18502/acta.v59i12.8068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Coronavirus infectious disease 2019 (COVID-19) is confirmed to develop neurocognitive complications. In the present paper, we describe two patients with laboratory-confirmed COVID-19 and excessive daytime sleepiness. In the present study, we reported two laboratory-confirmed cases of COVID-19 with excessive daytime sleepiness. Patients had drowsiness and mild confusion on presentation. In both cases, CNS infections, including meningitis and encephalitis, were ruled out. Both patients’ symptoms remarkably improved following the therapeutic course indicating the direct effect of SARS-CoV2 in sleep modulating centers on the brain. COVID-19 should be considered in patients with excessive daytime sleepiness and drowsiness in the current outbreak.
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24
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Izadi N, Najafi A, Saraei M. Metabolic syndrome and its determinants among professional drivers: a systematic review and meta-analysis. J Diabetes Metab Disord 2021; 20:2015-2023. [PMID: 34900837 DOI: 10.1007/s40200-021-00928-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 10/23/2021] [Indexed: 11/29/2022]
Abstract
Background Drivers are one of the trade unions that are most exposed to various health-related risks, especially metabolic diseases. The present study aimed to systematically assess the overall prevalence of metabolic syndrome and its determinants among drivers in the world. Methods All retrospective, cross-sectional, or prospective studies evaluating the prevalence and risk for metabolic syndrome and its main components among male professional drivers were eligible for the initial assessment. PRISMA guideline was used. Two blinded reviewers independently screened the titles and abstracts of the manuscripts followed by a deep assessment of the full texts for determining the inclusion appropriateness. Results In the final, 12 articles were eligible for the final analysis. Overall, 19,350 professional male drivers with a total average age of 43.06 years (ranged from 35.5 to 51.1 years) were included in the study. The prevalence of metabolic syndrome was estimated to be 32.8% (95%CI: 32.1% to 33.5%), and the major determinants of appearing this syndrome among professional drivers were advanced age, years of driving experience, higher body mass index, smoking, high cholesterol dietary regimen, high Framingham risk score, low regular exercising, history of diabetes mellitus, history of gout, and shift work pattern. Conclusion According to the 32.8% prevalence rate of metabolic syndrome among drivers, managerial measures are needed to prevent and control metabolic disturbances among professional drivers are recommended.
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Affiliation(s)
- Nazanin Izadi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Saraei
- Occupational Sleep Research Center, Tehran University of Medical Sciences, Tehran, Iran
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25
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Moharari R, Davani B, Pourfakhr P, Nooraie R, Khajavi M, Etezadi F, Najafi A. The effect of digital nerve block on the accuracy of hemoglobin monitoring during surgery: A randomized clinical trial. Acta Anaest Belg 2021. [DOI: 10.56126/72.4.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: The decision to transfuse blood products to patients during surgery is critical, due to the potential complications and costs of transfusion. Measuring hemoglobin level by spectrophotometry (SpHb) plays an important role in making this decision. The accuracy of SpHb depends on the finger perfusion. Since digital nerve blocks (DNB) can enhance blood circulation, we aimed at investigating DNB effects on the accuracy of SpHb.
Methods: Patients undergoing spine surgery were randomly assigned to two groups. Group A received DNB in the left hand, and group B received DNB in the right hand. In each group, the other hand was considered as the control. Rainbow adult ReSposable sensors were attached to the patients’ both hands. Before surgical incision and every 1.5 hours, the SpHb values of both hands and the perfusion index were recorded. Concomitantly, arterial blood samples were drawn and sent to the lab for hemoglobin concentration measurement. This served as the gold standard for assessing hemoglobin levels (labHb). We used a mixed-effects generalized linear model to test the effect of independent variables on the difference between SpHb and labHb at each time point.
Results: The SpHb displayed higher hemoglobin levels than those assessed by the lab. For lower labHb values, the SpHb-labHb differences were larger. A one-unit decrease in labHb increased the difference between SpHb and labHb by 0.56 g dL -1 , which was statistically significant.
DNB significantly increased the difference between SpHb and labHb by 0.42 g dL -1 . The effect of DNB on the difference between SpHb and labHb was significant up to three hours after the beginning of surgery (0.58 g dL -1 difference between blocked and non-blocked hands).
Conclusion: This study shows that, when hemoglobin levels are low, the accuracy of spectrophotometry decreases. Although DNB increases finger perfusion, it leads to an overestimation of hemoglobin levels by SpHb.
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Najafi A, Sadeghniiat Haghighi K, Mohammadnejad E, Dehghan Manshadi SA, Izadi N. Sick Leave Characteristics Among Nurses of a Referral Hospital During COVID-19 Pandemic. ACTA 2021. [DOI: 10.18502/acta.v59i10.7765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Hospital-related infections have been widely reported during the Covid-19 outbreak that exposes healthcare professionals to at greater risk of infection. This cross-sectional study was designed to evaluate the frequency of absenteeism in hospital staff during the first and second months of the Covid-19 pandemic, from 26 February until 19 April 2020. Occupational data and sickness absenteeism characteristics were collected from the records of the nursing management department. 304 (17.8%) had sick leave due to coronavirus or corona-like symptoms. Nurses and then nursing aid workers constituted the categories with more frequency of sick leave. The more median days of sick leave were observed among supervisors and midwives. About 80% of participants had typical symptoms of Coronavirus. In conclusion, the median days of sick leave due to coronavirus were not as high as we thought. This could be due to human resource shortage and insufficient knowledge regarding return-to-work guidelines in the early phase of this pandemic.
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Najafi A, Mahboobi M, Sadeghniiat Haghighi K, Aghajani F, Nakhostin-Ansari A, Soltani S, Jafarpour A, Afsar Kazerooni P, Bazargani M, Ghodrati S, Akbarpour S. Sleep disturbance, psychiatric issues, and employment status of Iranian people living with HIV. BMC Res Notes 2021; 14:338. [PMID: 34461988 PMCID: PMC8404356 DOI: 10.1186/s13104-021-05755-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/20/2021] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES There are limited studies on the psychological issues and sleep problems among the Iranian people living with HIV (HIV). In this study, we aimed to assess sleep disorders, psychiatric characteristics, and employment status among Iranian PLWH. RESULTS In total, 304 PLWH with a mean age of 40.01 (SD = 9.60) years participated in the study. About 72% of the participants had a global PSQI score of more than 5, with a mean score of 7.71 (SD = 3.31). About 55.6%, 50%, and 67.4% of subjects had abnormal scores for depression, anxiety, and stress. Unemployed participants had 2.13 times more chance (95% CI 1.01-4.53) of having poor sleep quality compared to employed patients, and stress increased its likelihood by 3.18 times (95% CI 1.47-5.88).
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Affiliation(s)
- Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Marzieh Mahboobi
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Khosro Sadeghniiat Haghighi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Faezeh Aghajani
- Research Development Center, Arash Women’s Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saber Soltani
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Jafarpour
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Afsar Kazerooni
- Enter for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Matin Bazargani
- HIV Expert of Deputy of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Ghodrati
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
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Sadeghniiat-Haghighi K, Mehrabinejad MM, Hajighaderi A, Najafi A, Rahimi-Golkhandan A, Zahabi A. Shift Work Disorder, Insomnia, and Depression among Offshore Oil Rig Workers. Iran J Psychiatry 2021; 16:162-167. [PMID: 34221042 PMCID: PMC8233558 DOI: 10.18502/ijps.v16i2.5817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective: Numerous offshore jobs require 24-hour tasks, such as in industrial workplaces (eg, oil rigs). The purpose of this study was to assess shift work disorder (SWD), insomnia, daytime sleepiness, and depression among Iranian offshore oil rig workers in different shift schedules. Method : This cross-sectional study was conducted on Iranian offshore oil workers at the Persian Gulf. A questionnaire package consisted of Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory (BDI- II), and SWD filled. The scores were calculated among different groups of shift schedules (fixed-day, fixed-night, swing and standby shift workers). ISI, BDI-II, and ESS scores were also compared between individuals with or without SWD. Results: A total of 188 participants were recruited in the study, and all were male. The mean age was 37.06 ± 9.2 years. Among different shift schedules, the highest and lowest ISI and ESS scores were related to fixed-night shifts workers and fixed-day shift workers, respectively. ISI, ESS, and BDI mean scores in different shift schedules were not significantly different (p values = 0.14, 0.57, and 0.93, respectively). SWD was diagnosed in 57 (30.3%) of studied shift workers. The difference between SWD prevalence was not significant between different shift schedules (P value =0.13). Workers with SWD had higher ISI, ESS, and BDI-II score (P values <0.0001, <0.0001, and <0.0001, respectively) and workers without SWD had higher job satisfaction (p value = 0.04). Conclusion: SWD is considered as a serious health-related issue in Persian Gulf oil rig shift workers. Insomnia, daytime sleepiness, and depression are associated with SWD.
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Affiliation(s)
| | - Mohammad-Mehdi Mehrabinejad
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Abdolkarim Hajighaderi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Students Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ania Rahimi-Golkhandan
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Zahabi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Research and Technology Department, National Iranian Drilling Company (NIDC), Ahvaz, Iran
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29
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Najafi A, Sadeghniiat-Haghighi K, Akbarpour S, Samadi S, Rahimi B, Alemohammad ZB. The effect of apnea management on novel coronavirus infection: A study on patients with obstructive sleep apnea. Sleep Health 2021; 7:14-18. [PMID: 33153936 PMCID: PMC7607233 DOI: 10.1016/j.sleh.2020.09.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the frequency of coronavirus disease-2019 (COVID-19) and the effect of obstructive sleep apnea (OSA) management on COVID-19 among patients with confirmed OSA. DESIGN Cross-sectional telephone interview survey. SETTING Academic sleep labs. PARTICIPANTS Iranian adults ≥ 18 years old with confirmed OSA. RESULTS Among 275 participants with OSA, 20% (n = 55) were suspected to have history of COVID-19 but had no positive test, and 18% (n = 51) were in the definite COVID-19 group according to their reported symptoms or confirmed positive test. Having severe OSA (apnea hypopnea index ≥ 30) was associated with an increased risk of definite COVID-19, with an odds ratio (OR) with 95% confidence interval (95% CI) of 2.31 (0.87-5.55) compared to having mild OSA in definite COVID-19 group. Those not undergoing treatment for OSA had an OR (95% CI) of 2.43 (1.26-4.67) for definite COVID-19 compared to those accepting treatment in definite COVID-19 group. Total sleep times (TSTs) were 354, 340, and 320 minutes in healthy, suspected, and COVID-19 groups, respectively; TST was associated with COVID-19 (P-value = .04). Similarly, sleep efficiency (SE) scores were 75.7, 74.2, and 67.9% for the healthy, suspected, and COVID-19 groups, respectively (P-value = .005); Beck Depression scores were 13.8, 13.0, and 17.7, respectively (P-value = .056). CONCLUSIONS OSA as a proinflammatory condition with multiple comorbidities may be a contributing factor to developing COVID-19. Greater OSA severity, no treatment for OSA, and lower TST and SE were associated with increased COVID-19 prevalence among patients with OSA.
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Affiliation(s)
- Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahram Samadi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Besharat Rahimi
- Advanced Thoracic Research Center, Tehran University of Medical Sciences, Tehran, Iran
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30
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Mahboobi M, Najafi A, Nakhostin-Ansari A, Kazerooni PA, Bazargani M, Navaiian F, Akbarpour S. Depression, sleep quality and condom use amongst Iranian people living with human immunodeficiency virus. South Afr J HIV Med 2021; 21:1150. [PMID: 33391831 PMCID: PMC7756672 DOI: 10.4102/sajhivmed.v21i1.1150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 09/26/2020] [Indexed: 11/13/2022] Open
Abstract
Background Depression is a common mood disorder in people living with human immunodeficiency virus (PLWH) and is associated with risk-taking sexual behaviour. Objectives This study examines depression, sleep quality and condom usage amongst PLWH in Tehran, Iran. Method This cross-sectional study was undertaken between October and November 2019 on 298 PLWH referred to voluntary counselling and testing centres (VCTs) in Tehran. Participants provided information as per the following questionnaires: the Depression, Anxiety, Stress Scale (DASS), the Pittsburgh Sleep Quality Index Questionnaire and a demographic questionnaire that evaluated condom use. Results A total of 298 PLWH, of whom 202 (67.8%) were men with a mean age of 39.81 years, were enrolled in the study. The DASS classified 57% with depression. Fewer than 20% of these used condoms regularly. The majority of depressed patients were men (68.6%) and 31.4% were women. The depressed patients were more likely not to use condoms than those who were not depressed (adjusted odds ratio [OR] = 6.5; 95% confidence interval [CI], 3.70–11.42). The adjusted OR for not using a condom amongst the depressed was 7.12 times greater (95% CI, 5.85–10.11) than in those without depression. Conclusion Our findings suggest that depression is common amongst PLWH in Tehran and is associated with risk-taking sexual behaviour. Appropriate interventions are needed to address mental disorders in PLWH. It is recommended that patients be screened regularly for symptoms of depression and, where indicated, counselled and managed.
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Affiliation(s)
- Marzieh Mahboobi
- Department of Epidemiology and Biostatistics, School of Public Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvin Afsar Kazerooni
- Center for Communicable Disease Control, Ministry of Health and Medical Education, Tehran, Iran
| | - Matin Bazargani
- HIV Expert of Deputy of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Navaiian
- HIV Expert of Deputy of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Akbarpour
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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31
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Akbarpour S, Asgari S, Najafi A, Sadeghniiat K, Gholamypour Z. The association between body mass index and risk of obstructive sleep apnea among patients with HIV. J Res Med Sci 2021; 26:123. [PMID: 35126586 PMCID: PMC8772514 DOI: 10.4103/jrms.jrms_803_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 12/23/2020] [Accepted: 07/12/2021] [Indexed: 11/04/2022]
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32
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Sadeghniiat-Haghighi K, Mehrabinejad MM, Najafi A, Shabani M, Akbarpour S. Cluster analysis of insomnia symptoms during COVID-19 pandemic: a general population web-based survey in Iran. Sleep Sci 2021; 14:63-68. [PMID: 34917275 PMCID: PMC8663724 DOI: 10.5935/1984-0063.20200087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2020] [Accepted: 12/03/2020] [Indexed: 11/20/2022] Open
Abstract
Objective To investigate the prevalence of insomnia and its different phenotypes as well as their association with fear of COVID-19 in the general population. Material and Methods This was a cross-sectional study conducted using an online survey (e-poll). All available participants who completed the online survey form were included in the current study. All individuals with a history of sleep problems were excluded. A questionnaire package consisted of insomnia severity index (ISI), and FCV-19 for corona fear was administered for all participants. Insomnia was defined as ISI≥8. Insomnia phenotypes were considered as: (a) DIS: difficulty initiating sleep; (b) DMS: difficulty maintaining sleep; (c) EMA: early morning awakening; and (d) combined insomnia. Results A total of 1,223 participants [827 (67.6%) female, mean age=39.82±10.75 years old], enrolled in the current survey. Based on ISI, 675 (55.2% [95%CI=52.40-57.98]) were categorized into the insomnia group. Insomnia was more prevalent in females (p=0.006), participants with 50 years old or higher (p=0.04), or high fear of COVID-19 (p<0.0001). Totally, 67.4%, 66.4%, and 55% of all participants had DIS, DMS, and EMA, respectively, in the current outbreak. Besides, 79% had impaired daily functioning, 51.6% had impaired quality of life, and 62% were worried about their sleep problem. Notably that a considerable percentage of individuals with normal ISI scores had at least one insomnia phenotype or impaired daily functioning and quality of life. Further analyses revealed a significant increasing trend in all four insomnia phenotypes prevalence with an increase in fear of COVID-19 (all p-values<0.0001). Conclusion Individuals with higher age, female gender, or higher fear of COVID-19 are at higher risk of all types of insomnia as well as impaired daytime performance or quality of life.
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Affiliation(s)
- Khosro Sadeghniiat-Haghighi
- Tehran University of Medical Sciences, Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences - Tehran - Iran
| | | | - Arezu Najafi
- Tehran University of Medical Sciences, Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences - Tehran - Iran
| | - Mahya Shabani
- Tehran University of Medical Sciences, Students' Research Committee - Tehran - Iran
| | - Samaneh Akbarpour
- Tehran University of Medical Sciences, Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences - Tehran - Iran
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Ayaz M, Najafi A, Karami MY. Thin Split Thickness Skin Grafting on Human Acellular Dermal Matrix Scaffold for the Treatment of Deep Burn Wounds. Int J Organ Transplant Med 2021; 12:44-51. [PMID: 34987732 PMCID: PMC8717875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND Use of AlloDerm™ is highly suggested for the treatment of deep burns and burn sequela reconstruction. Scar formation and contracture are recognized as long-term consequences of split-thickness skin autografting, which is applied for full-thickness burn injuries. Mature fibroblasts, in the absence of dermis, seem to secrete collagen in the reformed scar pattern. OBJECTIVE To process AlloDerm™ from fresh allograft and use it as a dermal substitute for covering deep wounds in burn patients and evaluate its effectiveness. METHODS In this case-series, 7 patients with deep burn wounds involving different locations on the body surface were exposed to combined AlloDerm™ (processed from fresh human allograft) with thin split thickness skin autograft on it. On the 5th post-operative day, wound dressings were changed to evaluate the graft survival with the human acellular dermal matrix scaffold. To determine the skin profiles, follow-ups continued for at least 6 months. RESULTS The results showed excellent graft take, good elasticity, acceptable thickness, and little contracture and scarring according to fix surgeon assessment in 6 patients. Graft rejection happened only in one patient with chronic electrical injury. CONCLUSION AlloDerm™ derived from cadaver skin and combination of it with thin split thickness skin auto grafting constitute a cost-effective and favorable option for the treatment of deep burn wounds in our center, considering the increased tendency of the population towards organ donation in the event of brain death.
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Affiliation(s)
- M. Ayaz
- Correspondence: Mehdi Ayaz, Division of Burn and Reconstructive Surgery, Department of Surgery, Shiraz University of Medical Sciences, Shiraz, Iran.E-mail:
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Sadeghniiat-Haghighi K, Najafi A, Eftekhari S, Tarkhan S. Insomnia and its association with absenteeism: A cross-sectional study among Iranian nursing team. Sleep Sci 2021; 14:305-310. [PMID: 35087626 PMCID: PMC8776262 DOI: 10.5935/1984-0063.20200106] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 01/25/2021] [Indexed: 12/02/2022] Open
Abstract
Objective Given the potential impact of insomnia on nurses’ performance, it is assumed
that insomnia is associated with their absence from work. The present study
aimed to determine the insomnia status and its association with absenteeism
among a selective group of Iranian healthcare providers. Material and Methods This cross-sectional study was conducted on 304 healthcare providers working
at Imam-Khomeini hospital complex in Tehran. The study population were
assessed by insomnia severity index for characterization of insomnia
symptoms. The data of absenteeism was collected from the employees’
attendance system of hospital’s nursing and staff department. The
multivariable linear regression model used for predicting determinants of
insomnia and absenteeism in nursing team. Results Different degrees of insomnia was found in 79.9% of the study population,
which 57.2% suffered from mild insomnia, 21.4% from moderate insomnia, and
1.3% from severe insomnia. The prevalence of insomnia was significantly
higher in persons who were absent from their workplace frequently, or left
because of illness. The mean days for total absenteeism in healthcare
workers with moderate to severe insomnia was significantly higher than
others with mild and no insomnia. In multivariate analysis, having night
shifts and the severity of insomnia could predict absenteeism in studied
population. Discussion A majority of healthcare workers suffer from insomnia that may lead to their
work absenteeism and decreased performance. Proper administrative and
individuals for management of sleep problems is required to avoid long hours
of absenteeism among nursing team.
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Affiliation(s)
| | - Arezu Najafi
- Tehran University of Medical Science, Occupational sleep research
center - Tehran - Iran
| | - Sahar Eftekhari
- Tehran University of Medical Science, Center for Research on
Occupational Disease - Tehran - Iran
| | - Samareh Tarkhan
- Tehran University of Medical Science, Center for Research on
Occupational Disease - Tehran - Iran
- Corresponding author: Samareh Tarkhan
E-mail:
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Mousavi Movahed SM, Akbarpour S, Saraei M, Mahboobi M, Najafi A, Taghizadadeh F. Hypertension and Decreased Glomerular Filtration Rate Among Commercial Drivers. Iran J Kidney Dis 2021; 1:17-21. [PMID: 33492300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/26/2020] [Accepted: 07/06/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Chronic Kidney Disease (CKD) is of high clinical importance due to cost of outcomes such as kidney transplantation. However, CKD is an overlooked disorder among commercial drivers. The present study aimed to evaluate hypertension and Glomerular Filtration Rate (GFR) among commercial drivers. METHODS In this cross-sectional study, a total of 903 commercial drivers referred for obtaining their health license were recruited. After obtaining informed consent, a questionnaire consisted of demographic characteristics was completed. Blood pressure, level of lipid profile, blood sugar, blood urea nitrogen, and plasma creatinine were measured. Chi-square and independent T-test were used for data analysis. RESULTS All participants were male. The mean ( ± SD) age and Body mass index were 42 ± (10) years and 27 ± (4) kg/m2, respectively. Of 903 studied cases 40 (4%) had GFR < 60. Increased age and high blood pressure had a significant association with reduced GFR (P < .0001). The ones with sleep apnea were more likely to have GFR < 60, however, the association was not statistically significant after adjusting for related risk factors. CONCLUSION Older age and hypertension are considered as risk factors for CKD among commercial drivers. Obstructive sleep apnea also should be kept in mind as a possible risk factor that requires further elucidation and management.
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Affiliation(s)
| | | | | | | | - Arezu Najafi
- Occupational Sleep Research Center (OSRC), Baharloo Hospital, Tehran University of Medical Sciences, Iran.
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Vahed M, Ramezani F, Tafakori V, Mirbagheri VS, Najafi A, Ahmadian G. Molecular dynamics simulation and experimental study of the surface-display of SPA protein via Lpp-OmpA system for screening of IgG. AMB Express 2020; 10:161. [PMID: 32880759 PMCID: PMC7471224 DOI: 10.1186/s13568-020-01097-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/26/2020] [Indexed: 11/10/2022] Open
Abstract
Staphylococcal protein A (SpA) is a major virulence factor of Staphylococcus aureus. S. aureus is able to escape detection by the immune system by the surface display of protein A. The SpA protein is broadly used to purify immunoglobulin G (IgG) antibodies. This study investigates the fusion ability of Lpp'-OmpA (46-159) to anchor and display five replicate domains of protein A with 295 residues length (SpA295) of S. aureus on the surface of Escherichia coli to develop a novel bioadsorbent. First, the binding between Lpp'-OmpA-SPA295 and IgGFc and the three-dimensional structure was investigated using molecular dynamics simulation. Then high IgG recovery from human serum by the surface-displayed system of Lpp'-OmpA-SPA295 performed experimentally. In silico analysis was demonstrated the binding potential of SPA295 to IgG after expression on LPP-OmpA surface. Surface-engineered E. coli displaying SpA protein and IgG-binding assay with SDS-PAGE analysis exhibited high potential of the expressed complex on the E. coli surface for IgG capture from human serum which is applicable to conventional immune precipitation.
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Affiliation(s)
- M. Vahed
- Department of Toxico/Pharmacology, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Niayesh Highway, Valiasr Ave, Tehran, 6153-14155 Iran
- Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Niayesh Highway, Valiasr Ave, Tehran, 14155-1817 Iran
| | - F. Ramezani
- Physiology Research Center, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - V. Tafakori
- Department of Cell & Molecular Sciences, Faculty of Biological Sciences, Kharazmi University, Tehran, Iran
| | - V. S. Mirbagheri
- PhD Student in Fisheries Products Processing Group, Faculty of Fisheries and Environmental Sciences, Gorgan University of Agricultural Sciences and Natural Resources, Gorgan, Iran
| | - A. Najafi
- Department of Environmental and Industrial Biotechnology, National Institute of Genetic Engineering and Biotechnology (NIGEB), P.O.BOX: 14965/161, Tehran, 1497716316 Iran
- Present Address: Department of Cell and Molecular Biology, Uppsala University, P.O. Box 256, 751 05 Uppsala, Sweden
| | - G. Ahmadian
- Department of Environmental and Industrial Biotechnology, National Institute of Genetic Engineering and Biotechnology (NIGEB), P.O.BOX: 14965/161, Tehran, 1497716316 Iran
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Abstract
BACKGROUND The screening of risk factors for sleep apnea among drivers with safety-sensitive jobs is considered as an issue of utmost importance in a safe transportation system. OBJECTIVE This study was conducted to assess the risk factors of sleep apnea among locomotive drivers. METHODS The present research is a cross-sectional study conducted in Baharloo Hospital, Tehran University of Medical Sciences, Iran. The study population included 281 locomotive drivers referred for their annual physical examination. Demographic characteristics, Epworth Sleepiness Scale (ESS), blood pressure, body mass index (BMI), neck circumference, and laboratory measurements including fasting blood sugar (FBS), cholesterol, high density lipoprotein, and low-density lipoprotein were recorded for each participant. Blood pressure ≥140/90 mmHg, history of drug use, BMI > 35 kg/m2, age >50 years, and neck circumference >40 cm were defined as risk factors for obstructive sleep apnea (OSA-RFs). RESULTS All participants were male with a mean age of 43±10 years. The mean BMI was 26.9±3.9 kg/m2. Also, the mean FBS and Total cholesterol of participants was 96.9±24.9 and 181.7±41.8, respectively. Among participants, 166 (59.9%) drivers had two or more risk factors of obstructive sleep apnea (OSA-RFs)CONCLUSIONS:The findings of this study indicated a high prevalence of obstructive sleep apnea among locomotive drivers. Therefore, further research is warranted to re-evaluate the current screening regulations of diagnosing sleep apnea among locomotive drivers.
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Affiliation(s)
- Maryam Saraei
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Arezu Najafi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ehsan Heidarbagi
- Occupational Sleep Research Center, Baharloo Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Abstract
Patients with Chiari type I malformation may also present with sleep disordered breathing mainly central sleep apnea. Here, we report a patient with Chiari I malformation referred to our clinic because of snoring and sleep disordered breathing. He was a 28-year-old man referred to us for evaluation of snoring. An overnight polysomnography revealed central sleep apnea. On further evaluation of central sleep apnea, the patient found to have Chiari malformation type I on brain MRI. The patient developed obstructive sleep apnea after surgery for Chiari malformation. Accordingly, pap titration was performed for the patient's obstructive sleep apnea. In patients with central sleep apnea comprehensive evaluation of predisposing causes is required. Lesions of central nervous system including Chiari malformation should not be overlooked. Furthermore, after treatment of central sleep apnea follow up PSG is warranted to confirm newly emerged sleep breathing disorder such as obstructive sleep apnea.
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Affiliation(s)
- Hamed Amirifard
- Tehran University of Medical Sciences, Occupational Sleep Research Center, Baharloo Hospital - Tehran - Iran
| | - Khosro Sadeghniiat-Haghighi
- Tehran University of Medical Sciences, Occupational Sleep Research Center, Baharloo Hospital - Tehran - Iran
| | - Arezu Najafi
- Tehran University of Medical Sciences, Occupational Sleep Research Center, Baharloo Hospital - Tehran - Iran
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Saraei M, Najafi A, Heidarbagi E, Rahimi-Golkhandan A. Evaluation of Metabolic Syndrome among Locomotive Drivers. Occup Med (Lond) 2020. [DOI: 10.18502/tkj.v11i3.2588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction: Screening of risk factors for metabolic syndrome among commercial and train drivers that are considered safety sensitive jobs, is an important issue in safety of transportation system. Metabolic syndrome is consisted of disturbed lipid profile, high blood pressure, and high waist circumference. It can lead to decrease the quality of life and higher health associated costs for these patients. This study aimed to assess risk factors for metabolic syndrome among train drivers.
Methods: This cross-sectional study was conducted on 281 train drivers referred to their annual health examinations to Occupational Medicine Clinic of Baharloo Hospital, Tehran University of Medical Sciences. Demographic characteristics of participants were recorded. Blood pressure, body mass index and waist circumference of drivers were measured. Participants’ blood sample for fasting blood sugar, triglyceride, high and low density lipoproteins were collected. Metabolic syndrome was defined according to the NCEP ATP III criteria.
Results: All of the participants were males. Their mean age and BMI was 43±10 year and 26.60±3.67 Kg/m2, respectively. Fifty three (21%) of the participants were diagnosed with metabolic syndrome. The more frequent risk factor for metabolic syndrome was triglyceride more than 150mg/dl.
Conclusion: Findings of the present study revealed high prevalence of metabolic syndrome among train drivers. Further studies are needed for screening the metabolic syndrome in this occupational group as it is a sensitive occupation.
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Najafi A, Naeimabadi N, Sadeghniiat-Haghighi K, Salmani-Nodoushan M, Rahimi-Golkhandan A. Continuous positive airway pressure adherence in patients with obstructive sleep apnea syndrome. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Mehrabinejad M, Najafi A, Hajighadery A, Saraei M, Izadi N, Alemohammad Z. Association of sleep characteristics and respiratory symptoms at a smelting factory. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Aminian O, Noorani A, Sadeghniiat-Haghighi K, Najafi A. Evaluation of psychomotor performance in patients with obstructive sleep apnea syndrome. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Sadeghniiat-Haghighi K, Najafi A, Adib B, Alemohammad Z, Akbarpour S. Association of rem characteristics as a state marker of depression among Iranian patients: a case-control study. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sadeghniiat-Haghighi K, Najafi A, Rahimi-Golkhandan A, Akbarpour S, Mohammadzade M. Insomnia severity and depression among patients with obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sadeghniiat-Haghighi K, Afzalinejad E, Najafi A, Alemohammad Z, Akbarpour S. Development of an objective tool for predicting obstructive sleep apnea among adults: PAN apnea index. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- P. Bayati
- Department of Physics, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
| | - A. Najafi
- Department of Physics, Institute for Advanced Studies in Basic Sciences (IASBS), Zanjan 45137-66731, Iran
- Research Center for Basic Sciences & Modern Technologies (RBST), Institute for Advanced Studies in Basic Sciences, Zanjan, Iran
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Najafi A, Schuldt M, Pham T, Michels M, Schlossarek S, Carrier L, Jimenez C, Zaccolo M, van der Velden J, Kuster D. PKA’s favorite son: prioritizing phosphorylation of phospholamban over cardiac troponin I contributes to diastolic dysfunction in hypertrophic cardiomyopathy. J Mol Cell Cardiol 2018. [DOI: 10.1016/j.yjmcc.2018.05.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Saraei M, Najafi A, Heidarbagi E. Prevalence of metabolic syndrome and risk factors of obstructive sleep apnea among locomotive drivers. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arshi S, Salmani M, Sadeghniiat-Haghighi K, Najafi A, Alavi S, Shamsipour M. Prevalence of obstructive sleep apnea among adults in north-west of Iran. Sleep Med 2017. [DOI: 10.1016/j.sleep.2017.11.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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